Neuroma
A neuroma is a scar of nerve tissue that typically forms on the branch of a sensory nerve after an injury to that nerve. Neuromas often occur in patients after surgical procedures such as abdominal or cranial operations, as a result of cuts and lacerations that affect nerves and after amputations.
Operative procedure to treat a neuroma. A standard carpal incision is extended into the hand to identify the neuromas to an amputated index finger. A second incision is made on the dorsum (upper surface) to carry out the nerve repair between the nerve graft and the digital nerves. Inset: nerve repair. Illustration from Surgery of the Peripheral Nerve by Mackinnon and Dellon, reprinted with permission of Thieme Medical Publishers, Inc.
A neuroma frequently occurs as a knot in the region of a sensory nerve underlying a scar. These lesions can be very painful and can affect almost any part of the body.
Neuromas often respond well temporarily to nerve blocks using local anesthetic agents, which numb the area, and physicians may use this as a diagnostic tool. One of the treatments for neuromas is neurectomy, or resection (removal) of the nerve tissue. The surgeon will identify the nerve branch that has the neuroma and cut this branch above the mass. He or she will then cap the end of the nerve with cautery and place the nerve in a position where it is much less likely to form a neuroma.
Another treatment, as depicted in the figure, is resecting the neuroma and then grafting from the proximal (closest) cut end of the nerve to an appropriate target.